Self-Efficacy and Knowledge in Cardiotoxicity Management Among Pediatric Oncology Nurses: A Cross-Sectional Mediation Analysis
Aslı Akdeniz Kudubeş, Remziye Semerci Şahin, Eyşan Hanzade Savaş, Ayşe AyBackground:
Cardiotoxicity is a serious adverse effect of cancer treatment in children and can be reversible or irreversible, with irreversible forms involving permanent loss of cardiac muscle cells.
Objective:
This study aimed to examine pediatric oncology nurses’ self-efficacy and knowledge levels regarding the management of cancer treatment-related cardiotoxicity, to identify the sociodemographic and professional factors associated with self-efficacy, and to test whether knowledge functions as a mediator in the association between cardiotoxicity-related training and self-efficacy.
Methods:
In this descriptive, cross-sectional study, 122 nurses working in pediatric oncology units for at least 6 months (July 2024 to February 2025) completed the Information Form, the Nursing Self-Efficacy Scale for Managing Cancer Treatment-Induced Cardiotoxicity (NSS-CTC), and the Cardiotoxicity Knowledge Level Form for Pediatric Oncology Nurses (CKLF-PON). Data were analyzed with descriptive statistics,
Results:
The hierarchical model explained 72.0% of the variance in self-efficacy. Female sex (β=0.172,
Conclusions:
Clinical experience alone does not guarantee effective cardiotoxicity management. Structured, content-specific education and continuous professional development improve self-efficacy partly by enhancing objective knowledge.
Clinical Relevance:
Among pediatric oncology nurses, self-efficacy for managing cancer treatment-related cardiotoxicity was associated not with accumulated clinical experience but with 2 modifiable behaviors: participation in cardiotoxicity-specific training and regular engagement with the current literature, both of which operated partly through objectively measured knowledge.